Researchers in Saudi Arabia studied 92 children with type 1 diabetes to see if the way they take insulin changes their eating habits. Some kids used a pump that gives insulin continuously throughout the day, while others got insulin through multiple daily shots. The study found that both groups ate similarly overall, but kids who ate more fiber-rich whole grains had better blood sugar control. This suggests that what kids eat matters more than how they get their insulin, and doctors should focus on teaching all kids with diabetes about choosing healthier carbohydrates.

The Quick Take

  • What they studied: Whether the method of taking insulin (pump versus injections) affects eating habits and blood sugar control in children with type 1 diabetes
  • Who participated: 92 children and teenagers with type 1 diabetes from three hospitals in eastern Saudi Arabia, ranging from those using insulin pumps to those using daily injections
  • Key finding: The way kids took insulin didn’t change their overall eating patterns, but children who ate more fiber-rich whole grain foods had better blood sugar control, regardless of their insulin method
  • What it means for you: If your child has type 1 diabetes, focusing on eating whole grains and fiber-rich foods may help control blood sugar better than worrying about which insulin delivery method they use. However, this was a smaller study in one region, so talk with your child’s doctor before making changes.

The Research Details

This was a cross-sectional study, which means researchers looked at a group of children at one point in time rather than following them over months or years. Between September 2023 and March 2024, researchers at three hospitals in Saudi Arabia asked 92 children with type 1 diabetes and their families about their eating habits. They used a special questionnaire called the Perceived Dietary Adherence Questionnaire to understand what the kids ate during a typical week. The researchers then compared the eating patterns of children using insulin pumps (a small device that delivers insulin continuously) with those using multiple daily injections (getting insulin through shots several times a day). They also looked at blood sugar test results (called HbA1c) to see which eating patterns were connected to better control.

This research approach is useful because it gives a real-world picture of how children with diabetes actually eat and manage their condition in their daily lives. By looking at both insulin delivery methods at the same time, researchers could fairly compare whether the method itself influences eating choices. Understanding these patterns helps doctors know what advice to give families.

This study has some strengths: it included children from multiple hospitals, used a validated questionnaire to measure eating habits, and looked at actual blood sugar results. However, it’s a relatively small group (92 children) in one region of Saudi Arabia, so results may not apply everywhere. The study was done at one point in time, so we can’t know if eating habits changed over time. The researchers also noted that they need to do longer-term studies to confirm their findings.

What the Results Show

The main finding was surprising: children using insulin pumps and those using daily injections had very similar eating patterns overall. When researchers compared the two groups, there were no meaningful differences in how well either group followed healthy eating guidelines. This suggests that the insulin delivery method itself doesn’t automatically change what kids choose to eat. However, when looking at all the children together, those who ate more fiber-rich whole grain foods (like brown rice, whole wheat bread, and oatmeal) had better blood sugar control, shown by lower HbA1c numbers. This connection was strong and consistent. The researchers also found that water intake differed between the two groups, with pump users drinking more water, though the reason for this difference isn’t clear.

The study looked at several other eating behaviors including low-glycemic index foods (foods that don’t spike blood sugar quickly), overall carbohydrate distribution throughout the day, and intake of high-sugar and high-fat foods. None of these behaviors showed major differences between the pump and injection groups. This reinforces the main finding that insulin delivery method doesn’t seem to drive eating choices in these children.

Previous research has suggested that insulin pumps might give children more flexibility in eating because they can adjust insulin doses more easily. This study suggests that flexibility alone doesn’t automatically change eating patterns. The finding that fiber-rich foods help with blood sugar control aligns with many other studies showing that whole grains and high-fiber foods are beneficial for people with diabetes worldwide.

This study has several important limitations. First, it’s relatively small with only 92 children, so results might not apply to all children with type 1 diabetes. Second, it only looked at children in Saudi Arabia, where food availability and cultural eating patterns may differ from other countries. Third, the study captured eating habits at just one moment in time, so we don’t know if these patterns stay the same or change over months and years. Fourth, the study relied on families reporting what they ate, which can sometimes be inaccurate. Finally, the researchers couldn’t prove that eating fiber-rich foods directly causes better blood sugar control—they only found that these two things go together.

The Bottom Line

Based on this research, children with type 1 diabetes should focus on eating more fiber-rich whole grain foods like brown rice, whole wheat bread, oatmeal, and beans, regardless of whether they use an insulin pump or injections. This appears to help with blood sugar control. Doctors should teach all children with diabetes about choosing lower-glycemic index foods and distributing carbohydrates throughout the day. These recommendations have moderate confidence because the study is relatively small and was done in one region. Families should work with their diabetes care team before making major dietary changes.

This research is most relevant to children and teenagers with type 1 diabetes and their families, as well as pediatric diabetes doctors and nutritionists. It’s particularly useful for families deciding between insulin pumps and injections, as it suggests that eating patterns won’t automatically improve just by switching methods. However, families should still discuss which insulin delivery method is best for their individual situation with their doctor.

Improvements in blood sugar control from eating more fiber-rich foods typically take several weeks to a few months to become noticeable. Families should expect gradual improvements rather than immediate changes. Regular blood sugar monitoring and HbA1c tests (usually done every 3 months) will show whether dietary changes are working.

Want to Apply This Research?

  • Track daily servings of fiber-rich whole grain foods (target: 3-5 servings per day) and correlate with weekly average blood sugar readings to see the connection between these foods and better control
  • Set a specific goal like ’eat one whole grain food at each meal’ and use the app to log these choices daily, then review weekly to celebrate progress and identify which whole grain foods work best for your child
  • Create a monthly dashboard showing fiber intake trends alongside HbA1c results (when available) to visualize the relationship between dietary choices and blood sugar control over time

This research suggests associations between eating patterns and blood sugar control but does not provide medical advice. Parents and caregivers should not change their child’s diet or insulin regimen based solely on this study. Always consult with your child’s endocrinologist or diabetes care team before making changes to diet, insulin delivery methods, or diabetes management. This study was conducted in Saudi Arabia and may not apply to all populations. Individual responses to dietary changes vary, and personalized medical guidance is essential for managing type 1 diabetes.